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Segment Reporting
 3 Months Ended
Mar. 31, 2023
Segment Reporting [Abstract]  
Segment Reporting Segment Reporting
The Company currently operates in two major lines of business that are also the Company's reportable operating segments - the operation of surgical facilities and the operation of ancillary services. The Surgical Facility Services segment includes the operation of ASCs, surgical hospitals and anesthesia services. The Ancillary Services segment consists of multi-specialty physician practices. The "All other" line item primarily consists of the Company's corporate general and administrative functions.
The following tables present financial information for each reportable segment (in millions):
Three Months Ended March 31,
20232022
Revenues:
Surgical Facility Services$649.0 $578.8 
Ancillary Services17.2 17.4 
Total$666.2 $596.2 
Adjusted EBITDA:
Surgical Facility Services$118.8 $101.0 
Ancillary Services(1.4)0.1 
All other(27.3)(24.0)
Total$90.1 $77.1 
Reconciliation of Adjusted EBITDA:
(Loss) income before income taxes$(0.4)$44.1 
Net income attributable to non-controlling interests(26.1)(30.6)
Interest expense, net46.8 56.3 
Depreciation and amortization33.7 27.4 
Equity-based compensation expense4.2 3.7 
Transaction, integration and acquisition costs (1)
12.8 7.1 
Net loss (gain) on disposals, consolidations and deconsolidations (2)
10.5 (0.1)
Litigation settlements and regulatory change impact (3)
8.0 (30.8)
Undesignated derivative activity0.6 — 
Adjusted EBITDA$90.1 $77.1 
(1)This amount includes transaction and integration costs of $12.5 million and $7.1 million for the three months ended March 31, 2023 and 2022, respectively. This amount further includes start-up costs related to de novo surgical facilities of $0.3 million for the three months ended March 31, 2023, with no comparable costs for the three months ended March 31, 2022.
(2)Includes an $8.5 million loss for the three months ended March 31, 2023 related to a surgical facility with a book value of the asset group in excess of the fair value based on a letter of intent.
(3)This amount includes a litigation settlement loss of $3.0 million and a gain of $32.8 million for the three months ended March 31, 2023 and 2022, respectively. This amount also includes other litigation costs of $0.6 million and $2.0 million for the three months ended March 31, 2023 and 2022, respectively. Additionally, the three months ended March 31, 2023, includes $4.4 million related to the impact of recent changes in Florida law regarding the use of letters of protection.
March 31,
2023		December 31,
2022
Assets:
Surgical Facility Services$6,049.2 $6,001.1 
Ancillary Services41.4 41.7 
All other552.7 639.3 
Total assets$6,643.3 $6,682.1 
Three Months Ended March 31,
20232022
Cash purchases of property and equipment:
Surgical Facility Services$23.8 $17.7 
Ancillary Services0.5 0.2 
All other— 0.3 
Total cash purchases of property and equipment$24.3 $18.2